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艾滋病患者如何进行护理
随着艾滋病这一危害人类健康的严重疾病在世界范围的蔓延，我国艾滋病流行趋势十分严峻。在全民预防AIDS传播的队伍中，护理人员始终站在这道防线的最前沿。在管理措施、技术服务、心理护理等方面发挥了重要作用。
艾滋病的护理对策：
培训护理人员
艾滋病同性恋患者的生存
艾滋病的流行在我国比西方国家几乎晚了十年，艾滋病的护理对中国护理人员是一个新的领域，所以护士在进行相关临床实践之前必须得到系统的培训。需要每一个从事这项工作的护士具备较高的职业素质和一定的思想境界，以及不断更新的专业理论知识和娴熟的操作技能。为此我们举办艾滋病护理培训班;组织全院护士专题护理查房;邀请国外护理专家来院指导工作;组织护士参加在北京举行的多种国内国际艾滋病会议;派出护理骨干到国外进修和培训，使护理人员对艾滋病的流行趋势，治疗进展，发病特点等有全新的了解，以增强护理人员的紧迫感，责任感及做好充分的心理的技术的准备，以胜任这项艰巨而有意义的工作。
建立合理、实用的消毒隔离制度及灵活的护理管理模式
护理HIV感染的病人是一件极具挑战性但又非常有价值的任务。高度复杂的心理社会因素使护理工作面临着极大的困难，当然，直接护理的基本技巧与护理其他疾病没有什么区别，特殊措施之一是消毒隔离及管理问题。
由于艾滋病是传染病中最新的一族，隔离消毒措施没有现成的经验可参考。人们谈“艾”色变，特别是我院收治第一例病人时，大家如临大敌，似乎怎么隔离都不过份。消毒更严格，病人用物几乎能焚烧的全部焚烧，其他一律高压消毒。但随着知识的普及，了解到HIV感染主要是通过性接触，血液、体液暴露和母婴垂直传播，不会通过日常接触传播，因此，目前的消毒隔离措施更实际和实用了。
1.消毒隔离
1)病房要求：什么样的人需住单间呢?病情复杂、严重;有机会性感染;不合作，用血和其他分泌物、排泄物污染环境的病人;有相当经济能力，提出特需服务的病人。
2)皮肤粘膜的保护：为防止HIV感染，护士实施护理时需穿隔离衣，戴一次性手套。特别是手是接触HIV感染的第一屏障，因此当处理血液、体液及污染物品时必须戴手套。护理病人之后及护理另一个病人之前必须洗手。
3)对操作的要求及污染物的处理：
护士操作前应向病人做好解释，取得合作，对不合作的病人或污染危险性较大的操作应由技术熟练的二人配合，操作尽量集中，严格规范，避免误伤自己。当进行侵入性治疗及护理操作时，如手术、穿刺、注射等，要注意对利器的处理，用过的利器必须放到特殊的容器中。器械用千分之五的“84”消毒液浸泡后再经高压灭菌，一次性注射器、输液器、针头经消毒毁形处理后由卫生局指定厂家回收。被血液、体液污染的被服类经高压消毒后再与一般同类物统洗。
4)送检标本处理：病人的送检标本放在固定的容器里，容器外不得污染，
并有特殊标记，专送检测。标本用过经消毒处理后再弃掉。
5)尸体处理：处理尸体应戴手套，穿隔离衣。伤口及渗出部位需妥善处理， 房间、物品必须进行终末消毒，消毒方法同一般终末消毒方法。
2.灵活的管理模式：
在收治的病人和感染者中，除了危重病人外，一律收在普通病房。除对他们采血时谨慎防护之外，不需要更多的隔离措施。年节还可回家团聚，组织他们定期参加医院组织的红丝带俱乐部活动，为他们提供宽松的治疗环境。同时性传播疾病中心门诊除有热线电话，中外名专家的面对面咨询、治疗、专业指导以外，护理管理模式是可匿名匿址的挂号、抽血、取药、治疗等单独设立的一条龙服务。提供了环境方便优美，设备先进，消毒隔离措施严密的高效优质服务。
心理护理多层次，个性化
在艾滋病尚无特异性药物的情况下，减轻病人身心痛苦，防止恶化，提高生存质量是一项重要手段。护士与病人直接接触最多，因此是医疗工作中最有力的助手。
艾滋病是一个长病程的致死性疾病，除对症治疗护理外，患者在病程中会遇到各种心理问题。大部分病人面对死亡、社会孤立、人们的歧视做出的反应包括否认、愤怒、抑郁及自杀倾向等。不同病人不同发病时期都会有不同的心理问题。一般的技术护理是千人一面的，而心理护理则是以不同人群，不同文化背景，不同的社会境况及不同个性素质，因人而异提供不同层次的个性化的心理护理。
例如：一个医学界的高级知识分子患者，生病前他事业有成，依据马斯洛的基本需要层次论，我们认为他已达到了最高层次的需要，即实现了人的自身价值，在这种情况下，突如其来的HIV感染，使他最不能忍受的是社会的歧视，家人的冷漠，这是他最大的心理问题和负担。针对此护士在与其交流时注意到对其人格的格外尊重和无微不至的护理，同时配合单位及家人的关心和亲情，满足其较高层次的心理需求，收到较好的效果。
又如对外宾的心理护理：本着人道主义和国际主义的原则和道德义务，以外事无小事的责任心，克服语言障碍，用娴熟的操作技术和周到的生活护理，使一位因感染HIV后自杀未遂造成全身粉碎性骨折的女外宾患者感到了人间的温暖，好转回国时与护士依依不舍。
再如对心理变态、行为偏激的患者的护理对策是不急不躁、理解、包容、善待，使一个敌视一切人，报复社会的年轻厨师受到感动，多次住院延长了生命。
还如对一个年仅十七岁因输血感染HIV的受害者，针对他的心理护理是帮助他及家人克服感染HIV后的心理障碍，使他们懂得延长生命就是希望，在休息、营养、保健、防止并发症等方面指导他们。同时帮助他们呼吁社会的支持，保障治疗费用，提高了生存质量。
最后，强调家庭和社会环境对艾滋病患者的心理支持是非常重要的，对患者生存时间及生命质量起着至关重要的作用，是医疗护理手段不可替代的，我院收治的患者中不乏因社会及家人的不理解、不支持而使患者生存质量和生存期都受到了影响的例子，有的仅几个月就去世了。
总之，每一个感染者都有自己的故事，无论何种原因感染此病都是不幸的悲剧。护士在实施心理护理时，不需要了解其隐私的部分，但很需要对其一般的社会、心理因素有一个具体的评估，以便对其进行有针对性的帮助和护理。
实施护理中的困惑
1.交流和指导障碍，由于怕触动患者的隐私，许多护士在与病人交流沟通时顾虑颇多，浮于表面化。同时中国国情对性的问题比较敏感，甚或是禁区，且护士多为年轻女性，对病人安全性行为指导等有难于启齿的困难。
2.在护理工作中护士被感染HIV的机会较多，护理人员最大的心理问题是恐惧，除应有的奉献精神外，有关部门是否需要研究对从事此项工作受到意外损伤的医务人员给予必要的预防补救措施，提供药物及设立补偿机制等，以保障医务人员的安全，免除后顾之忧。
How to care of AIDS patients
With AIDS, which is damaging to human health, the spread of serious diseases in the world, the trend of China's AIDS epidemic is very serious. To prevent the spread of AIDS in the popular team, nurses always stand in the forefront of this line of defense. In the management measures, technical services, psychological care, has played an important role.
AIDS care responses:
Training for care workers
AIDS and gay life in patients with
The AIDS epidemic in China than in Western countries, almost a decade later, AIDS care in China is a new area of nursing, so nurses during clinical practice related to the system must be prior to training. Needed every one involved in the work of nurses with high professional quality and a certain ideological realm, as well as continuously updated professional theoretical knowledge and skilled operational skills. To this end we have organized AIDS care training courses; special care organizations, hospital-wide nursing rounds; to invite foreign experts to come to hospital care and directing work; organization of nurses to participate in Beijing in a variety of domestic and international AIDS Conference; send the backbone of nursing education and training abroad, so that Nurses AIDS epidemic trends, treatment progress, disease characteristics of a new understanding to enhance nurses sense of urgency, responsibility and make full preparations for the psychological techniques to qualify to the hard and meaningful work .
A reasonable and practical disinfection and isolation system and flexible care management model
Care and HIV infected patients is a challenging but very worthwhile task. Highly complex psychological and social factors so that nursing is facing great difficulties, of course, the basic skills of direct care and nursing is no different from other diseases, disinfection and isolation is one of special measures and management issues.
Because AIDS is the latest in a family of infectious diseases, quarantine disinfection measures the experience not readily available for reference. People talk about "Ai" pale, especially the first patients admitted to our hospital, everyone was facing a formidable enemy, it seems that how isolated not be overstated. More stringent sterilization, the patient with the burning of almost all the materials burned all the other high-pressure sterilization. But with the popularization of knowledge and understanding that HIV infection is mainly through sexual contact, blood, body fluid exposure and vertical transmission is not spread through casual contact, therefore, the current disinfection and isolation measures to be more realistic and practical.
1. Disinfection and isolation
1) Ward asked: What kind of people need to live in a single operations? Disease complex, serious; there are opportunistic infections; co-operative, with blood and other secretions, fecal pollution of the environment of the patient; a considerable financial capability and special needs services,病人.
2) The skin and mucous membrane protection: To prevent HIV infection, nurses need to wear when nursing gown, wearing disposable gloves. Especially the hands is the first contact with HIV infection barrier, so when dealing with blood, body fluids and contaminated articles must wear gloves. After patient care and nursing must wash hands before another patient.
3) The operation of the processing requirements and pollutants:
Nurse before the operation the patient should be well explained, to obtain cooperation, uncooperative patients or risk of contamination of the larger of the two-person operation by the skilled co-operation as far as possible to focus, strict specifications, to avoid accidentally injure themselves. When it comes to invasive medical treatment and care operations, such as surgery, puncture, injection and so on, should pay attention to the handling of a sharp weapon, used the weapon to be placed on a special container. Equipment used 5/1000 of "84" and then soaked in disinfectant by high pressure sterilization, disposable syringes, infusion sets, needles, sterile disfigurement after treatment by the health bureau has designated recycling factory. The blood, body fluids contaminated clothing type high-pressure sterilization and then wash with the general integration of similar objects.
4) banning specimen processing: the patient's submission on the fixed specimen containers, the container shall not be polluted
And other special marks, special delivery inspection. Specimens used sterilized and then discarded.
5) The body of treatment: dealing with dead bodies should wear gloves, wear a gown. Wounds and seep sites require proper handling, room, items must be terminal disinfection, disinfection method, with the general method of terminal disinfection.
2. Flexible management model:
In the treated patients and infected persons, in addition to critically ill patients, all received in the general wards. In addition to careful protection when they are outside the blood does not require additional quarantine measures. New Year can return to his hometown, hospital organization, they are organized on a regular basis to participate in the activities of the Red Ribbon Club to provide them with relaxed therapeutic environment. At the same time sexually transmitted diseases clinic addition to the hotline center, Chinese and foreign experts face to face consultation, treatment, other than the professional guidance, care management model is the registration site can be anonymous hide, blood, and obtain the medicines and treatment to establish a separate one-stop service. Provides a convenient and beautiful environment, advanced equipment, strict disinfection and isolation measures and efficient services.
Psychological care multi-level, personalized
In the AIDS cases, no specific drugs to alleviate physical and mental suffering of the patient to prevent the deterioration and improve the quality of life is an important means. Nurses, the most direct contact with patients, medical work is therefore the most powerful aide.
AIDS is a long course of the fatal disease, in addition to symptomatic treatment and care, the patient will encounter in the course of the disease in a variety of psychological problems. Most patients facing death, social isolation, people's response to discrimination, including denial, anger, depression and suicidal tendencies. Incidence of different patients in different periods will have a different psychological problems. Thousands of ordinary care is the technical side, while the psychological care are based on different groups, different cultural backgrounds, different social situations and different personal qualities, varies with different levels of individualized psychological care.
For example: a high-level intellectuals in the medical profession, patients, illness ago he established in a career, according to Maslow's hierarchy of basic needs, and we think he has reached the highest level of need, that is, self-realization of human values, in this cases, the sudden HIV infection, make him the most I could tolerate the discrimination in the community, family indifference, which is his greatest psychological problems and burden. Exchange for this nurse noted with special care to respect their personality and meticulous care, at the same time with the unit and their families the care and affection, to meet their higher level of psychological needs, receive good results.
Another example is the psychological care of the foreign guests: the spirit of humanitarian and internationalist principles and moral obligation, something other than the sense of responsibility is no small matter to overcome the language barrier, with the operation of skilled technical and thoughtful life care, so that an HIV infection caused by the body after the suicide attempts in patients with comminuted fracture of the female foreign guests feel the human warmth, improved return reluctant to part with the nurse.
Another example of abnormal psychology and behavior in patients with extreme care solution is not rash, understanding, tolerance, treat, so that a hostile to all people in retaliation for the community was moved by the young chef, hospitalized several times to extend their lives.
If one is also only 17-year-old HIV-infected blood transfusion victims of psychological care is against him and his family helped him to overcome the psychological barrier after HIV infection, so that they know how to prolong life is the hope that in the rest, nutrition, health care, prevent complications and so on to guide them. At the same time helping them to appeal to social support, protection of the treatment costs, improved quality of life.
Finally, the emphasis on family and social environment of psychological support for AIDS patients is very important for survival time and quality of life plays a vital role, is an irreplaceable means of medical care, and I no shortage of patients admitted to hospital because of social and his family do not understand and does not support Ershi the quality of life and survival in patients have been affected example, some only a few months died.
In short, each infected person has his own story, no matter what the reasons are infected with the disease, unfortunately, tragedy. Nurses in the implementation of psychological care, the need to understand some of their privacy, but it is necessary for its general social and psychological factors have a specific assessment for them targeted help and care.
The implementation of nursing care confusion
1. Barriers to communication and guidance, due to fear of provoking the privacy of patients, many nurses communicate with patients when the concerns many, floating on the surface. The same time, China's national conditions on sensitive issues, or even closed, and the nurses, mostly young women, for patient safety guidance, etc. are difficult to speak about sexual difficulties.
2. In the nursing work opportunities for nurses were infected with HIV are more psychological problems nurses biggest fear, in addition to proper dedication, the authorities need to study this work has been engaged in accidental injury to give the necessary medical personnel preventive remedial measures to provide medicine and set up a compensation mechanism to protect the safety of medical personnel, eliminating the worry.
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